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General NPI Number Information
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NPI Number | 1205053634
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Entity Type | Individual
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Provider Name | TIMEKA HAYES LMHC
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 217 PAGE BACON RD
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City | MARY ESTHER
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State | FL
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Zip | 32569-1685
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Country | US
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Telephone | 850-792-5102
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4627
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City | FORT WALTON BEACH
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State | FL
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Zip | 32549-4627
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Country | US
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Telephone | 850-792-5102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 13614
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 77587
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License Number State | FL
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